Transgender and nonbinary (TGNB) persons have profound and broad-ranging health disparities, smoking included. Existing evidence suggests that TGNB persons smoke more, suffer disproportionately from diseases and conditions associated with smoking, and often lack access to health care. Despite a documented higher prevalence of smoking, little is known about general and culturally specific factors that affect smoking behaviors or hinder cessation. A better understanding of key factors that serve as barriers to, and facilitators of, smoking cessation and treatment utilization has important implications for the development of tailored interventions for the TGNB population.
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References
1.
U.S. Department of Health and Human Services (USDHHS). The Health Consequences of Smoking—50 Years of Progress. Atlanta, GA: U.S. Department of Health and Human Services, Centers for Disease Control and Prevention, Coordinating Center for Health Promotion, National Center for Chronic Disease Prevention and Health Promotion, Office on Smoking and Health, 2014.
2.
Centers for Disease Control and Prevention. Tobacco product use and cessation indicators among adults—United States, 2018. Morb Mortal Wkly Rep. 2019; 68:1013–1019.
3.
BuchtingFO, EmoryKT, Scout, et al. Transgender use of cigarettes, cigars, and e-cigarettes in a national study. Am J Prev Med. 2017; 53:e1–e7.
4.
JamesS, HermanJ, RankinS, et al.The report of the 2015 U.S. transgender survey. National Center for Transgender Equality, 2016. Available at: https://www.transequality.org/sites/default/files/docs/USTS-Full-Report-FINAL.PDF (accessed November18, 2019).
5.
MeyerIH, BrownTN, HermanJL, et al.Demographic characteristics and health status of transgender adults in select US regions: Behavioral Risk Factor Surveillance System, 2014. Am J Public Health. 2017; 107:582–589.
6.
TooriansAW, ThomassenMC, ZweegmanS, et al.Venous thrombosis and changes of hemostatic variables during cross-sex hormone treatment in transsexual people. J Clin Endocrinol Metab. 2003; 88:5723–5729.
7.
GoorenLJ, GiltayEJ, BunckMC. Long-term treatment of transsexuals with cross-sex hormones: extensive personal experience. J Clin Endocrinol Metab. 2008; 93:19–25.
8.
GetahunD, NashR, FlandersWD, et al.Cross-sex hormones and acute cardiovascular events in transgender persons: a cohort study. Ann Intern Med. 2018; 169:205–213.
9.
SørensenLT. Wound healing and infection in surgery: the pathophysiological impact of smoking, smoking cessation, and nicotine replacement therapy: a systematic review. Ann Surg. 2012; 255:1069–1079.
10.
MatthewsAK, CesarioJ, RuizR, et al.A qualitative study of the barriers to and facilitators of smoking cessation among lesbian gay, bisexual, and transgender smokers who are interested in quitting. LGBT Health. 2017; 4:24–33.
11.
GamarelKE, MereishEH, ManningD, et al.Minority stress, smoking patterns, and cessation attempts: findings from a community-sample of transgender women in the San Francisco Bay Area. Nicotine Tob Res, 2016; 18:306–313.
12.
ShiresDA, JaffeeKD. Structural discrimination is associated with smoking status among a national sample of transgender individuals. Nicotine Tob Res. 2016; 18:1502–1508.
13.
EliasonMJ, DibbleSL, GordonR, SolizGB. The last drag: an evaluation of an LGBT-specific smoking intervention. J Homosex. 2012; 59:864–878.
14.
BaskervilleNB, DashD, ShuhA, et al.Tobacco use cessation interventions for lesbian, gay, bisexual, transgender, queer youth and young adults: a scoping review. Prev Med Rep. 2017; 6:53–62.
15.
GonzalesG, Henning-SmithC. Health disparities by sexual orientation: results and implications from the Behavioral Risk Factor Surveillance System. J Community Health. 2017; 42:1163–1172.
16.
SellRL. Challenges and solutions to collecting sexual orientation and gender identity data. Am J Public Health. 2017; 107:1212–1214.
17.
DelahantyJ, GanzO, HoffmanL, et al.Tobacco use among lesbian, gay, bisexual and transgender young adults varies by sexual and gender identity. Drug Alcohol Depend. 2019; 201:161–170.
18.
GrantJ, MottetL, TanisJ, et al.National transgender discrimination survey report on health and health care. Washington, DC: National Center for Transgender Equality and the National Gay and Lesbian Task Force, 2010. Available at: https://cancer-network.org/wp-content/uploads/2017/02/National_Transgender_Discrimination_Survey_Report_on_health_and_health_care.pdf (accessed November18, 2019).
19.
ColemanE, BocktingW, BotzerM, et al.Standards of care for the health of transsexual, transgender, and gender-nonconforming people, version 7. Int J Transgenderism, 2012; 13:165–232.
20.
American Medical Association. Advocating for the LGBTQ community. Available at: https://www.ama-assn.org/delivering-care/population-care/advocating-lgbtq-community (accessed November18, 2019).
21.
American Psychological Association. Information and resources regarding LGBT health disparities and advocacy from the Office on Sexual Orientation and Gender Diversity. Available at: https://www.apa.org/pi/lgbt/resources/lgbt-health (accessed November18, 2019).
22.
KrisbergK. Meeting the Demand for Better Transgender Care. Association of American Medical Colleges (AAMC) News, 2018. Available at: https://news.aamc.org/diversity/article/meeting-demand-better-transgender-health-care/ (accessed November18, 2019).
23.
EmoryK, BuchtingFO, TrinidadDR, et al.Lesbian, gay, bisexual and transgender (LGBT) view it differently than non-LGBT: exposure to tobacco-related couponing, e-cigarette advertisements, and anti-tobacco messages on social and traditional media. Nicotine Tob Res. 2019; 21:513–522.
24.
LeeJG, MatthewsAK, McCullenCA, MelvinCL. Promotion of tobacco use cessation for lesbian, gay, bisexual, and transgender people: a systematic review. Am J Prev Med. 2014; 47:823–831.
